Rating of attributes and skills that make a competent Audiologist
4.4 Current challenges faced by Audiologists in South Africa
Table 4.4 Challenges that frequently arise during counseling of adult clients who need hearing aids
Theme Comments made- examples Frequency
(Percentage)
Client
“do not take responsibility of the hearing loss”,
“subconsciously have not accepted they need a hearing aid”, “it takes a lot of time to break through”, “unrealistic expectations”, lack of understanding”, “poor socioeconomic status”,
“poor caregiver or family support”, “not wanting people to see that they are wearing hearing aids”.
“Unrealistic expectations from the client
regarding hearing aid (magic fix)”, “uninformed public due to restriction of the HPCSA on advertising”
80 (52.6%)
Audiologist
“language barrier”, “not having skills, knowledge and resources to counsel”, “still lack clinical experience”, “time constraints”, “use of an interpreter is also difficult”, “lack of counseling skills”, “not enough time for effective aural rehabilitation”, “the fact that I am young and do not have a hearing loss and trying to counsel them”, “poor follow up”
15 (9.9%)
Hearing Aids
“clients want to purchase hearing aids that are cheaper and no necessarily the best fit”,
“complaints with regards to sound quality”,
“expense of hearing aids”, “adherence to hearing aids”, “financial”, “previous experiences/stigma of hearing aids”, “ non-compliance of hearing aids”, “family forces the client to get hearing aids”, “misconceptions regarding hearing aids”, reluctant to wear hearing aids”, “cost”, “cosmetic issues, “do not want to wear HA all the time”
42 (27.6%)
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Overall similar themes appeared between the participants who responded to what in their opinion are the challenges faced when dealing with adults who are fit with hearing aids. The top themes were lack of financial resources to afford hearing aids or to obtain a technology level that is appropriate for the needs of the client, language barrier, unrealistic expectations and non-compliance of wearing hearing aids for an ample amount of time before deciding to withdraw.
Table 4.4 above presents a summary of the themes related to the Client, Audiologists and Hearing Aids. Under the theme of client the most common challenges faced by the audiologists are clients not taking responsibility for their hearing loss, unrealistic expectations and the lack of understanding regarding hearing and hearing aids.
Challenges faced by the Audiologists were grouped into; the language barrier between the clinician and the client, not having adequate skills and knowledge to counsel the client as well as the lack of time. Finally the theme of hearing aids face challenges of the client not understanding the limitations of hearing aids, financial constraints to hearing aids and the stigma related to them.
59 4.5 Training in counselling
4.5.1 Types of counseling covered during professional training
Participants indicated that during their professional training the following three types of counseling were covered; informational counseling, rational acceptance and adjustment counseling. The majority off participants indicated that their professional training encompassed informational counseling whilst rational acceptance and adjustment counseling received less attention. Sixty-nine percent (69%) of the participants indicated that their professional training covered all three types of counseling.
The majority of the participants also indicated that between the three types of counseling trained, they were able to spend more time on informational counseling than rational acceptance and adjustment counseling. A large number of participants (67%), stated that all three types of counseling coursework was covered during professional training whilst only 48% of the participants were offered the opportunity to practise all three types of counseling. In contrast to this 3% of the participants did not cover coursework on the three types of counseling whilst 11% of the participants did not receive any opportunity to practise the three types of counseling. This indicates a large difference between theories covered in counseling versus the practise covered in all three types of counseling during audiology training indicating a gap in audiology curricula in South Africa.
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Table 4.5 Cross tabulation of the three types of counseling received in coursework versus practise during audiology training
Cross Tabulation
All three types of counseling during audiology training (coursework versus practise)
Practise in all 3 types
of counseling Total
Yes No
Training received in all three types
of counseling
Yes
Count 67 37 104
Percentage training received in all three types of counseling
64.4% 35.6% 100.0%
Percentage practise in all three types of
counseling 93.1% 46.3% 68.4%
No
Count 5 43 48
Percentage training received in all three
types of counseling 10.4% 89.6% 100.0%
Percentage practise in all three types of
counseling 6.9% 53.8% 31.6%
Total
Count 72 80 152
Percentage training received in all three
types of counseling 47.4% 52.6% 100.0%
Percentage practise in all three types of
counseling 100.0% 100.0% 100.0%
In Table 4.5 above, indicates a cross tabulation of 152 participant responses of course work versus ability to practise all three types of counseling during audiology training. Analysis conducted using the McNemar Test which is a statistical test used on
61
paired nominal data; revealed a value of p = 0.0 therefore this indicates a statistically significant value as the p- value< 0.05.
4.5.2 Perception of counseling skills
Questions 5-8 outlined in Figure 4.7 analysed the participants’ perception of their training and views on whether audiologists are confident to provide counseling.
62 Figure 4.7 Participants agreeing to statements related to adult hearing loss
2(1%) 3(2%) 0
1(1%) 1(1%) 3(2%) 1(1%)
6
26(18%) 29(19%) 13
15(10%) 6(4%) 1(1%) 6(4%) 1(1%)
57(39%) 37(25%)
34
41(28%) 21(14%)
8(5%) 21(14%) 7(5%)
54(36%) 69(46%)
83 73(49%)
78(52%) 71(47%) 78(52%) 56(37%)
9(6%) 12(8%)
19 19(13%)
43(29%)
67(45%)
43(29%)
86(57%)
0 20 40 60 80 100 120
8. Audiologists feel confident counseling (n=148) 7. Audiologists are adequately trained to provide counseling to
adult clients (n=150)
6. Do you feel adequately trained to counsel adult clients (n=149) 5. Do you feel adequately trained to counsel adult clients and their
significant other (n=149)
4. Adults with hearing loss who receive counseling perceive less of a handicap than the adults whom do not receive counseling (n=149)
3. Adults with untreated hearing loss avoid social gatherings (n=150)
2. By increasing knowledge and ways to cope with hearing loss,it decreases communication breakdowns, irritation and degraded…
1. Counseling is an important realm of audiology practise when dealing with adults with acquired hearing loss (n=149)
Frequency